HomeMy WebLinkAboutSWG2022-00391 - SWG As-Built - 6/5/2023 RECORD DRAWING (ASBUILT) pg. 1 MASON COUNTY PUBLIC HEALTH
PARCEL IDENTIFICATION
Permit Number SWG 2022-00391 Assessor Parcel # 32021-55-02030
Applicant Name BRENDA BAKKEN Subdivision (Name/Div/Block/Lot)
Applicant Address 221 E BALLANTRAE DR
City, State, Zip SHELTON, WA 98584 Installer Name GOLDY EXCAVATING
Site Address 10 E HAMMOND PL Designer Name ADAM HUNTER
INSTALLATION CHECKLIST
0 Full System Installation 0 Septic Tank Only ❑ Drainfield Only ❑ Repair
System Type SIMPLE PRESSURE Pretreatment Type N/A
>5 ft. from foundation? - - ❑ N/A 0 YES ❑ NO
>50 ft. from wells? - }f� ❑ 0 0
Z >50 ft. from surface water? 1� L5 ❑ 0 ❑
HCleanout between building and tank? - - - - -APR -t-1 tQ23 0 0 0
U Tank baffles present? - ❑ 0 0
aBy 24" access risers over each compartment? 0 0 0
W Effluent filter installed?- ❑ 0 0
N 1200 HOUSE BROTHERS
Septic tank size _gal Manufacturer
--..0 D-box water level and speed levelers used? - - 0 N/A ❑ YES ElNO
X0 Manifold/D-box accessible from surface?- - 0 0 0
COE Check valves installed? - - ❑ 0 ❑
0Q
2 40
2 Transport Line Size Schedule/Class
Bedrooms installed (check one) 0 2 ❑ 3 ❑4 0 5 0 6
>10 ft. from foundation?- - ❑ N/A 0 YES ❑ NO
0 >100 ft. from wells?- - 0 0 0
W >100 ft. from surface water? - - 0 0 0
Er_ >10 ft. from potable water lines?- - ❑ 0 ❑
Z > 5 ft. from property lines and easements?- - CI 0
Zia,
> 30 ft. from downgradient curtain/foundation drains? - - 0 0 0
tz
Drainfield level and observation ports present - - 0 0 0
0 Graveless chambers or ❑ Clean gravel used? (check one)
Proper cover installed over drainfield?- - 0 0 0
Pump tank setbacks consistant with septic tank? - - ❑ N/A ✓❑ YES ❑ NO
Pump tank size 1200 HOUSE BROTHERS
gal Manufacturer
< 24" access riser(s) and accessible from surface?- - 0 0 0
I—
a Alarm or Control Panel Installed? - - 0 0 0
E Control Panel equipped with Timer/ ETM / Counter- - 0 0 0
m
a Pump installed in ❑ Bucket or 0 On Block or ❑ Other
a Pump Make/Model ZOELLER 152 Floats or� ❑ 0 Transducer
a Tank draw down 2.75 in/min Pump capacity 66 gpm Squirt Height 5 ft
Pump on time 0.9 MIN Pump off time 6 HRS Daily flow set at 240 gpm
revised 1,22,2014
RECORD DRAWING (ASBUILT) pg. 2 MASON COUNTY PUBLIC HEALTH
RECORD DRAWING
❑ Drainfield&
manifold orientation
&layout
❑ Trench/bed
dimensions and
critical distances
within layout
El Septic/pump tank
placement
SEE ATTACHED
▪ Location of
buildings
• Observation ports&
clean-out locations
❑ Location of wells,
surface water,&
roads
El Undisturbed native
soil between
trenches
El North Arrow
If the designer or installer feel the need for additional information/comments, it may be attached. 1
Record drawing may also be on a seperate page attached. No. Pages Attached
CERTIFICATION OF INSTALLATION
INSTALLER DESIGNER
/certify that I installed the system in accordance with I certify that the system has been installed in accor-
the septic design stamped "APPROVED"by Mason dance with the septic design stamped "APPROVED"by
County Public Health and that any deviations shown Mason County Public Health and that any deviations
here have been cleared/approved by both the designer shown here have been cleared/approved by both
and Mason County Public Health and meet all State myself and Mason County Public Health and meet all
and Mason County Codes. State and Mason County Codes
I further certify that all information contained on this 1 further certify that all information contained on this
form and atta hed Re d Drawing is accurate. form and attached Record Drawing is accurate.
5/20/23
Signatur f Ins eller Date
JAKE GOLDY 6/1/23
Printed Name of Signeeifro • .F..
i 1�
MASON COUNTY PUBLIC HEALTH i :a!,Af
The undersigned approves this Installation Report and
Record Drawing on behalf of Mason County Public Z'r ' €
: ,? . ,•:f��
Health: .:41
SI�xVti7 fi
r 2 i".' AOAIAJ HUNTER •• +$�
.L.... r.�...24-c•� ,
Signature of Environmental Health Specialist Date (designer's stamp, signature and date)
THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE
revised 122/2014
I5/15/23
EAST HAMMOND RD 1I
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T. I /l(J ice: ADAM J.HUNTER `::: %
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600FT2 DRIP R/A
�i DRVE
PRE-TREATMENT MAY S&REQUIRED
I SCALE-1"=20'-0"
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Y EXISTING 2 BDRM RES /q * ^
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a �VED
Q —STUBOUT/CLEANOUT MASON CO0 JUN v 5 2023
W T &v 7Rp
__,SEPTIC TANK REr A MENTAL HEALTH
o
--PUMP CHAMBER
O / E- INSPECTION PORTS/LAT.CLEANOUTS
50'
% ' 59.------
/ ,------ ,------
PRESSURE TEST COMPLETED BY INSTALLER
VALVE BOX SQUIRT HT: 60"
DRAWDOWN: 2.75 IN/MIN
TIMER SETTINGS-
NEW TEST HOLE IN THE RESERVE AREA,SOILS BELOW:
ON: 0.9 MIN
(C..Av . ij-1 Le- '2-`4 •• OFF: 6 HRS
JIM HUNTER & ASSOC. CONTRACTOR
P.O. BOX 162, OLY,WA 98507 GOLDY SEPTIC
753-1226
1HANDASSOCIATES@HOTMAILCOM INSTALL DATE- 5/4/23
RECORD DRAWING SITE ADDRESS/LEGAL
10 E HAMMOND PL
OWNER- BRENDA BAKKEN --
FINAL DATE- 5/4/23
INo 32021-55-02030 SITE#